Senior Workers’ Compensation Claims Specialist - AZ - On Site

Distro
Arizona
Workplace: OnsiteFull timeUSD 48,000 - 69,000 annuallyFunction: People, HR & TalentExperience: 4-5 yearsEducation: bachelorsSkills: ["Analytical thinking","Critical thinking","Communication","Negotiation","Organizational skills"]

Manage complex, multi-state workers’ compensation claims from inception through closure with minimal supervision. Conduct in-depth investigations and compensability analysis, review medical documentation, assess exposure/reserves, and support fiscally sound settlement decisions. Serve as a consultant and primary client contact for risk mitigation and return-to-work strategies, coordinating with TPAs, defense counsel, medical providers, and injured workers. Mentor junior claims staff and drive process improvements using claim trends and client feedback.

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FursaFursa
Distro
Distro
1 day ago

Senior Workers’ Compensation Claims Specialist - AZ - On Site

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Last checked: 4 hours agoStatus: Live

Job Summary

Manage complex, multi-state workers’ compensation claims from inception through closure with minimal supervision. Conduct in-depth investigations and compensability analysis, review medical documentation, assess exposure/reserves, and support fiscally sound settlement decisions. Serve as a consultant and primary client contact for risk mitigation and return-to-work strategies, coordinating with TPAs, defense counsel, medical providers, and injured workers. Mentor junior claims staff and drive process improvements using claim trends and client feedback.
Location: Arizona
Workplace: Onsite
Employment Type: Full time
Job Function: People, HR & Talent
Seniority: Mid level

Key Responsibilities

  • •Lead comprehensive investigations of complex workers’ compensation claims, including coverage analysis, compensability determinations, medical review, and employer documentation.
  • •Evaluate and respond to TPA requests for reserve and settlement authority using exposure assessments based on medical prognosis, statutory benefits, vocational factors, litigation risk, and claim history.
  • •Serve as a high-level consultant to clients on risk mitigation by analyzing trends/systemic issues and recommending safety improvements to reduce workplace injuries and claim frequency.
  • •Provide empathetic guidance to injured workers and act as a liaison across clients, TPA adjusters, defense counsel, medical providers, and injured employees to ensure coordinated case management.
  • •Continuously monitor claim progression for timely action on updates and compliance, manage a portfolio of claims through closure, and mentor junior claims staff.
Travel: Low travel

Pay and Benefits

Salary: USD 48,000 - 69,000 annually

Key Requirements

  • •4–5 years of progressively responsible multi-state workers’ compensation claims experience, ideally with a TPA, insurance carrier, or employer-based risk management environment.
  • •In-depth knowledge of workers’ compensation laws, statutes, and regulations across multiple jurisdictions, with ability to interpret complex legal and medical documentation.
  • •Expertise conducting claims investigations, compensability/coverage verification, medical review, and advanced risk assessment.
  • •Advanced knowledge of reserve setting and financial exposure analysis, including trend evaluation and loss forecasting.
  • •Strong communication and interpersonal skills to explain complex workers’ compensation concepts to clients and injured workers, with case-management and confidentiality requirements (including HIPAA compliance).
Experience:4-5 yearsWorkers' compensationTPAInsuranceRisk management
Education:Bachelor's in Risk Management, Business Administration, Human Resources or equivalent
Skills:Analytical thinkingCritical thinkingCommunicationNegotiationOrganizational skills
Certifications:WCCAWCCPAICARMCWCPCPCU
Tech Stack:ExcelMicrosoft OfficeOutlookMicrosoft TeamsWordPowerPointClaims softwareMedical management systems

Company Brief

Distro
Provides a SaaS platform to simplify app distribution and release management, helping developers and teams build, share, and deploy mobile and web app builds to testers and stores.
Industry: Developer Tools
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